Driving Education in Airway, Voice, & Swallowing Care

Martin Brodsky, PhD, ScM previews two exciting upcoming events: the ASHA Health Care Summit 2025 on ICU collaboration in May, and a September CME on multidisciplinary airway, voice, and swallowing care. Dr. Brodsky also shares the latest research and clinical insights in the field of speech-language pathology.

Transcript

Paul Bryson: Welcome to Head and Neck Innovations, a Cleveland Clinic podcast for medical professionals exploring the latest innovations, discoveries, and surgical advances in otolaryngology head and neck surgery.

Thanks for joining us for another episode of Head and Neck Innovations. I'm your host, Paul Bryson, Director of the Cleveland Clinic Voice Center. You can follow me on Twitter @PaulCBryson, and you can get the latest updates from Cleveland Clinic Otolaryngology - Head and Neck Surgery by following @CleClinicHNI on Twitter, that's @CleClinicHNI, on LinkedIn at Cleveland Clinic Otolaryngology - Head and Neck Surgery, and Instagram at Cleveland Clinic Otolaryngology. 

Today, I'm excited to welcome back Dr. Martin Brodsky, Section Head of Speech-Language Pathology here in the Head and Neck Department at Cleveland Clinic. If you haven't listened to his previous episode on our podcast, I encourage you to do so. Dr. Brodsky, welcome back to Head and Neck Innovations.

Martin Brodsky: Thanks for having me, Paul. Pleasure to be here.

Paul Bryson: Yeah, since it's been just a little bit of time since we last sat together, can you just provide the listener with just your background and where you're from and what your interests have been as you've joined the group and started your practice here?

Martin Brodsky: Sure. I'm a clinical speech pathologist, I spend a lot of time in the clinic to begin. But on the research side of the world, which is my primary appointment, I do a lot of critical care, intensive care research, specifically related to swallowing, voice, and airway. And in fact, that has been with me for coming up on 20 years now, so it's been a very strong interest for that period of time. I've been funded through NIH for a long period of time, working toward additional funding as well in that area, and looking forward to learning new things.

Paul Bryson: One of the things that I learned about just before we sat down today is an exciting collaboration with the American Speech-Language and Hearing Association, also known as ASHA, on Healthcare Summit 2025 Grand Rounds in the ICU, and I understand this is going to be an event taking place here at the Cleveland Clinic. What a cool opportunity. Can you give us a little preview of what this might entail and who will be participating?

Martin Brodsky: Yeah, this is going to be a really exciting event, and an event I think like none other, at least that I've seen in my career. So, it's a great opportunity for speech-language pathologists to attend. It is in fact somewhat limited to speech-language pathologists, it's geared toward them. So this will take place May 2nd to the 3rd, at our Beachwood Administrative Campus, so it's not on the main campus, but it's at a beautiful location in Beachwood, Ohio at the administrative campus, which has a fantastic facility there. So, everything's all going to be on that fourth floor there. We're going to be effectively taking up the entire fourth floor in two separate rooms for both the discussion that we're going to have during the main show, and to have lunch and snacks and to meet the various supporters of the conference. 

Paul Bryson: Very easy to get in and out from the highway.

Martin Brodsky: Incredibly, yeah.

Paul Bryson: There's places to stay nearby, there's even quite a bit of dining options nearby as well.

Martin Brodsky: Yeah, and you can park right outside the door for free. There's no charge whatsoever if you happen to be driving to that facility. Easily accessible, lots to do in Beachwood, the downtown Beachwood area. It's just an immense area for shopping and eateries and things like that. A lot of attraction in that area.

What makes this conference unique is that you're going to be put in touch as a participant with all of the players that you would normally see in the ICU. You're going to have first-hand access to those individuals in being able to have those conversations that you're not necessarily able to have during the business day, simply because you're working on cases, you're evaluating and treating patients, there's no time, as anybody who knows the ICU. Everybody is flitting about with lots to do, and very quickly things happen in the ICU. So under normal circumstances, you would go in, do your assessment, do your treatment, talk with whoever you need to speak with, and walk out, wash, rinse, repeat for every patient that you need to see there.

What makes this conference unique is that you're going to come face-to-face with an intensivist, a nurse practitioner, a respiratory therapist, an occupational therapist, a dietician, a palliative care specialist, one of the otolaryngologists that we work with. All of these folks, you're going to have first-hand access to, to be able to understand how they think about the ICU, what their particular roles are in ICU, and how they work best with speech-language pathology so that everybody comes together in this multidisciplinary team that really is what the ICU is about in 2025.

Paul Bryson: Well, I think it's going to be a great opportunity for people that are able to make it. It sounds like I could see this being a recurring event because I think you'll learn a lot, you'll learn a lot about what people might be interested in. I think these sorts of interactions lend themselves to even more questions in refinement for future summits.

Martin Brodsky: There's a great opportunity here for all kinds of learning as well. The first day is interactive and didactic sessions. So you'll be hearing from all of these different players in the ICU, but there is a lot of time that is devoted to questions and answers. In fact, about one third of the day is devoted to questions and answers relative to each of these sessions. So that's a huge highlight here, is to give you the opportunity to pick their brains and understand how they think about things.

Another portion of the day is case understanding, case building, where working through a case and being part of that multidisciplinary panel, where you'll be able to effectively choose your own adventure in terms of how we go about understanding the case. 

So to give you some idea of what's happening, the case will be presented. There'll be five panelists from the different disciplines that will take place there, but the audience will drive the discussion, thinking, what do we do next from their speech pathologist or medical understanding of what may happen next? The panelists will think about what that order is, they'll answer the questions that are appropriate to the order, but nobody is going to understand exactly what was the order in fact, for this real case. At the end, everybody will be understanding what that case really was and how things transpired.

Paul Bryson: Well, for more information on the ASHA Healthcare Summit 2025, please visit https://www.asha.org/events/health-care. That's https://www.asha.org/events/health-care. 

Well, switching gears a little bit, can you highlight some of the research that you've been a part of? Anything that you wanted to highlight? I know since you've been here, you've been expanding your research network across the system, both clinically and in our ICU settings. Anything that you wanted to talk about today or mention?

Martin Brodsky: Sure. There has recently been an influx of opportunity. Among those things are very specifically taking a look at the different ICUs and how they approach screening for dysphagia and for aspiration, once patients are extubated from mechanical ventilation. So, in addition to educating and working with the clinical folks and kind of fine-tuning their skills and getting everybody to participate and be reliable in those measurements, we're going to be taking a look at ways on how to prevent aspiration pneumonia very specifically.

And one of the most interesting projects that I actually just had the pleasure of discussing yesterday was bringing in this very unique device into the ICU that captures secretions in the oral cavity. For those of you who may know or don't know, the name of the product is called SWIK. The way that it works is similar to any suction device, but it has a wicking component to it that sits in the cavity between your lips and your teeth and the lower jaw. As it sits there, because of its length effectively from molar to molar as it goes around, it wicks the moisture in the secretions that happen to be in those areas and it pulls them into the vacuum tube, into the canister, and prevents any kind of drooling, most specifically.

But we're adapting this and we want to see if we can kind of reduce the work on the EVAC tubes in the endotracheal tubes that have vacuum pumps effectively attached to them right above the cuff, such that we can prevent the aspiration that's already occurred sitting on the cuff from getting into the lower airways. If we can capture those secretions in the oral cavity, this may be a possibility of reducing pneumonias while we're on ventilators.

Paul Bryson: Yeah, I mean, that sounds great. I mean, that'll be very interesting to see, and I think just even from sort of a quality of life, and it's a pretty intense time in the unit, to have family members be able to come to visit and maybe not have the secretion burden that they might see. It kind of adds to maybe comfort and maybe even just some patient dignity and stuff when they're in a, when in difficult time in the unit.

Martin Brodsky: That's exactly right. In fact, I was just in the ICU yesterday and one of the patients who happened to be awake, she was on a trach collar, but it was really difficult for her to manage her secretions. She was really burdened with that, and suctioning herself the entire time the team was rounding. Imagine taking that hour away from her and simply placing this device in her mouth where it automatically, if you will, takes away those secretions. She doesn't have to worry about a piece of plastic in her bed, she doesn't have to handle anything, the secretions are wicked away, and she doesn't have to deal with that. No more drooling, no more wet sheets. It's a huge quality of life and it's a huge safety thing, when we're talking about bacteria getting into the airways.

Paul Bryson: Yeah, it sounds like a great opportunity for further exploration.

Martin Brodsky: Yeah.

Paul Bryson: Well, I was going to say too, there's yet another CME opportunity that is going to take place in September of this year, and this will be really a multidisciplinary effort, I wanted to say led by you and my colleague, Claudio Milstein in speech pathology, that will really provide people the opportunity to look at voice, swallowing and sort of laryngology and speech-language pathology in general. Do you want to give us a preview of that CME conference?

Martin Brodsky: I'd love to. This, in addition to the ASHA Conference, is a great honor as well. This one is sponsored by our own department, and we will be at the Marriott Downtown Key Tower, right here in Cleveland, Ohio. It will take place September 4th through the 6th. The conference is focused on airway, voice, swallowing, and how they work together, the synergy as well as the downside of how they work together.

So the very first day, we have nine keynote speakers. It's a very unique conference in that way, and the keynotes for each of those three areas for airway, voice and swallowing are paired. We have one physician and we have one SLP, so you'll get to hear two different perspectives on that portion of what we do. The last three speakers are going to be talking about the overlaps from both a medical, a basic science, and a clinical standpoint in how airway, voice and swallowing mix with each other. There may very well be things that we do in one that aren't so great for the other, and maybe there's no effect. Maybe there's a beneficial effect too, for one. So, kind of sit and wait and find out. So, that's day one.

Day two, we have three parallel tracks in airway, voice and swallowing, all featuring Cleveland Clinic talent from all of the disciplines that are associated with this. We'll have otolaryngologists, allergists, neurologists, gastroenterologists, and of course, speech-language pathologists, among many of the professionals who are going to be speaking during that day.

And then we'll wrap things up on that Saturday the 6th, with kind of parallel tracks with different concepts with regard to functional airway, head and neck, and with functional neurological disorders. A little bit off the beaten path, but not unrelated to airway, voice and swallowing. And we'll wrap things up with all of our keynote speakers answering questions and thinking about how they have put things together across the conference and whether their minds have changed based on the evidence that they presented earlier in the conference. So, it's jam packed with a lot to do and it's all interactive.

Paul Bryson: Well, I'm really looking forward to it. I really commend you on putting these things together. It's not easy, and it takes a bit of time and effort, and we're grateful to have you. I know you've had experience with these sorts of things across your other organizational leadership roles with ASHA and other places. So, thank you for that.

Well, as we wrap up today, any final take-home messages for our listeners?

Martin Brodsky: I would say there's a lot happening here, a lot to learn in our Head and Neck Department, and more broadly, [our Integrated Surgical Institute] ISI is a great place to learn. We have many different things going on, from this podcast to external events and conferences, to all the places where we present the research that we do and the teachings that we have. So stay tuned, there's more to come.

Paul Bryson: Well, for more information on speech-language pathology at Cleveland Clinic, please visit clevelandclinic.org/speechtherapy, that's clevelandclinic.org/speechtherapy. And to speak with a specialist or submit a referral, please call 216.444.8500. That's 216.444.8500. Dr. Brodsky, thanks for joining Head and Neck Innovations.

Martin Brodsky: Thanks for having me, Paul. It was a pleasure to be here.

Paul Bryson: Thanks for listening to Head and Neck Innovations. You can find additional podcast episodes on our website at clevelandclinic.org\podcasts, or you can subscribe to the podcast on iTunes, Google Play, Spotify, SoundCloud, or wherever you listen to podcasts. Don't forget, you can access realtime updates from Cleveland Clinic experts in otolaryngology – head and neck surgery on our Consult QD website at consultqd.clevelandclinic.org/headandneck. Thank you for listening and join us again next time.